Abstract
BackgroundMultidrug-resistant tuberculosis (MDR-TB) is a growing public health concern globally. In Bhutan, the rates of MDR-TB are high. Data on the risk factors of MDR-TB that can help inform policies are limited in Bhutan. This study aimed to determine the risk factors associated with MDR-TB.MethodsA nationwide unmatched case-control study was conducted that included 79 MDR-TB cases and 118 controls. Data was collected by trained health workers through interviews using a structured questionnaire. Logistic regression analysis was performed to identify the risk factors associated with MDR-TB.ResultsThe mean age of the participants was 32.4 and 33.7 years among the cases and the controls, respectively. In the multivariate analysis, the odds of having MDR-TB was higher among those who slept for less than 9 hours a day (AOR: 2.77, 95%CI: 1.11–6.92), frequently travelled in public transport (AOR: 2.96, 95% CI: 1.36–6.48), and had previous TB treatment (AOR: 5.90, 95%CI: 2.55–13.64). A greater number of rooms was also marginally associated with odds of having MDR-TB.ConclusionsThe findings suggest previous TB treatment, inadequate sleep duration, and travelling by public transport to be the risk factors associated with having MDR-TB in Bhutan. Intensification of early case detection, strengthening directly observed treatment strategy, improving treatment adherence, and increasing awareness can help control the rising MDR-TB epidemic.
Highlights
In 2017, 10 million people had tuberculosis (TB) and around 1.3 million died from TB [1]
The odds of having Multidrug-resistant tuberculosis (MDR-TB) was higher among those who slept for less than 9 hours a day (AOR: 2.77, 95%CI: 1.11–6.92), frequently travelled in public transport (AOR: 2.96, 95% CI: 1.36–6.48), and had previous TB treatment (AOR: 5.90, 95%CI: 2.55–13.64)
The findings suggest previous TB treatment, inadequate sleep duration, and travelling by public transport to be the risk factors associated with having MDR-TB in Bhutan
Summary
In 2017, 10 million people had tuberculosis (TB) and around 1.3 million died from TB [1]. A majority (around 46%) of the cases occurred in the South-East Asia region [2]. 3.6% of the new cases and 17% of the previously treated cases developed multidrug-resistant TB (MDR-TB) in 2017 [1]. The prevalence of MDR-TB among new and previously treated cases was 1.6% and 29% respectively, in the South-East Asia region [2]. MDR-TB is difficult to treat, requiring longer treatment duration and hospitalization, and the drugs used are less effective, costly and produce severe side effects [3]. The prevention of initial infection, treatment and management of drug-susceptible TB adequately are keys to containing the spread of MDR-TB. Multidrug-resistant tuberculosis (MDR-TB) is a growing public health concern globally. Data on the risk factors of MDR-TB that can help inform policies are limited in Bhutan. This study aimed to determine the risk factors associated with MDR-TB
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